A prospective randomized trial of a residents-as-teachers training program

Purpose. To develop, implement, and evaluate a course for improving the teaching skills of surgery residents. Method. Responses from residents at four general surgery training programs to a needs assessment survey were used to develop a two-day course for improving teaching skills. Residents at two surgical training programs were randomly assigned to experimental and control groups, and experimental residents participated in and evaluated the newly devised course. Six to seven months later, experimental and control residents' teaching performances were evaluated using a five-station objective structured teaching evaluation (OSTE). Differences between the residents' performances were calculated using Mann-Whitney U, chi-square analysis, or Fisher's exact test. Results. Participating residents rated the course highly. They considered the interactive nature of the course its greatest strength. As measured by the OSTE, the performances of the residents differed least significantly in the feedback station, where the residents in the experimental groups showed significant improvement on only one of seven items at one institution, and only one of nine items at the other. The greatest differences occurred in the microskills teaching station, where the residents at one institution performed significantly better than did their control counterparts on four of five items and in overall performance. Conclusion. This study demonstrates the value of a needs assessment in developing a course to improve residents' teaching skills. Such courses must provide active learning with opportunities for practicing skills and, following the course, ongoing feedback to maintain changes in teaching behaviors. The curriculum developed in this study has been put into a transportable form that includes an instructor's manual providing guidelines and suggestions for implementation.